The stakes of this question are enormous. More than a quarter of adults and roughly 80 percent of adolescents worldwide fail to meet recommended physical activity levels, and physical inactivity is estimated to cause nearly 50 million new cases of non-communicable disease every year, with projected treatment costs of around 300 billion US dollars between 2020 and 2030. Childhood is widely seen as the most effective intervention point, because motor skill competence and physical activity form a self-reinforcing loop: children who move well tend to move more, and children who move more become better movers. Those who fall behind early can spiral into lifelong inactivity, which is why researchers are increasingly focused on the building blocks known as fundamental movement skills.

Fundamental movement skills are the basic movement patterns that children refine into the specialized actions needed for sports and other physical pursuits. They include locomotor skills such as running and jumping, object control skills such as catching, throwing and striking, and stability skills such as balancing on one foot or walking a beam. Physical education lessons are the traditional venue for teaching them, but the average school delivers only about 60 to 130 minutes of physical education per week, far short of the World Health Organization’s recommendation of at least 60 minutes of moderate to vigorous activity per day. Home-based activity is meant to fill the gap, yet excessive screen time is widely blamed for displacing it, and interventions that simply try to limit screen time have shown little success, partly because they create family conflict, demand parental energy that work and chores already consume, and run up against financial constraints such as lacking safe outdoor spaces.

The research team, led by Oscar O’Brien, proposes a broader conceptual category they call exergamoids: physical activities that involve sensors of physical activity controlling a games technology component of the experience. Exergames, in which players develop their health as they play a complete game, are one subset. Digital gamification of exercise, such as a leveling system layered onto a step counter, is another. The umbrella term is designed to organize a fragmented literature and allow findings to transfer across game types, hardware platforms and settings. What unites exergamoids is a feedback loop in which digital tracking of movement serves as input to a game system, and the game’s output augments the physically active experience, potentially motivating children to practice skills at home that they first learned at school.

To resolve the mixed evidence that has plagued this field, the researchers systematically searched ten databases, including PubMed, APA PsycINFO, SPORTDiscus, IEEE Xplore, ACM Digital Library, Scopus, ProQuest, Web of Science, ScienceDirect and Google Scholar, for studies published between January 2000 and December 2025. After screening 2,882 retrieved records, 545 abstracts, and hundreds of full texts against strict population, intervention, comparison and outcome criteria, they identified 12 studies containing 17 statistically significant comparisons across 28 experimental groups, covering children aged 4 to 12 in school, home and clinical-adjacent settings. The corpus included 22 unique games across four hardware platforms, most of them commercial titles, and the studies varied widely in whether they used researcher-made games with design enhancements, structured physical education sessions or loosely supervised play, and whether children received targeted coaching on movement skills.

The methodological innovation of the study lies in how it handled that variability. Rather than pooling effect sizes, which the authors argue would be undermined by heterogeneity and bias, they applied what they call systematic hypothesis testing, an approach built on set theory and order theory. They generated eleven plausible hypotheses about what causes variability in movement skill outcomes, each defined by mathematical constraints such as whether coaching, activity structure or exergame status has a positive, negative or zero effect. For every hypothesis, they predicted the direction of the outcome for each of the 17 comparisons based on how the experimental groups differed, and then checked whether the observed results matched the prediction. The hypothesis that survived every test was one in which skill improvement is a function of coaching and activity structure, while exergame status itself has exactly zero effect.

That finding is more surprising than it might appear. Many exergames can be operated with sloppy or incorrect movement patterns, since permissive sensors reward effort rather than technique, which has led critics to argue that skills learned in front of a screen will not transfer to the real world. Yet the meta-analysis found no evidence of a differential effect across the temporal, environmental and functional components of movement skill, meaning exergames worked equally well for locomotor, object control and stability skills. The authors draw on dynamic systems theory to explain why: acquiring a movement skill is a search for a correct movement pattern across many degrees of freedom, and what guides that search most effectively is knowledge of performance, the actionable feedback a human coach provides about how to adjust the movement. Simple scores and game rewards, which constitute knowledge of results, do not tell a child how to change their technique, so the accuracy of the simulation matters far less than the quality of the coaching around it.

The analysis also revealed a hierarchy of facilitation. Human-delivered coaching through verbal feedback and live demonstration had a strong effect on skill outcomes, and coaching delivered through digital media, such as skill demonstration videos within the game, also improved results. Activity structure showed a positive contribution as well, though it was not a statistically significant predictor on its own, likely because most studies varied coaching and game status rather than structure in isolation. Unstructured, free-play exergaming sessions consistently underperformed, mirroring broader evidence that unstructured activities are less effective for skill development than planned ones. In practice, the most successful interventions looked like well-run physical education lessons that happened to use a game: teachers selected activities aligned with developmental needs, modeled the skills, cued corrections, and adjusted difficulty for individual children.

The practical implications reach well beyond the school gym. The authors argue that low-barrier exergames, in which cheating produces no better score than playing correctly, deserve recognition as a distinct category, because their permissiveness lets children with imperfect technique participate and stay motivated while a coach fine-tunes the specificity of the activity through praise and goal setting. Exergames can also offer experiences that schools cannot easily provide, from virtual surfing and snowboarding between classes to practicing ball heading in virtual reality, where one study noted children reported reduced fear. They enable training during bad weather, promote exertion through heart-rate-driven game mechanics, and show hints of enhanced benefit for groups that traditional activity often misses, including children with developmental delays and those who skip physical education sessions. Barriers remain, including hardware costs, staff training, IT support and the need to choose games whose movements match the curriculum, but the researchers recommend that teachers and parents treat exergames as a legitimate, freely chosen option rather than a last resort.

Looking forward, the team outlines two frontiers that could push exergames beyond parity with traditional activity. Simulated coaching, in which games assess movement competence, deliver demonstrations and provide cues automatically, could embed the knowledge-of-performance feedback that currently depends on a human presence, making uncoached home play genuinely instructional. Co-teaching systems, in which a game acts as a teaching assistant that adapts around the teacher’s plans rather than displacing them, would require a new layer of interactivity but could draw on evidence that collaborative teaching yields benefits even when the second teacher is less skilled. The authors caution that their analysis operated at the whole-class level, did not examine individual participant characteristics, and could not assess whether small differences emerge in interventions longer than six to eight weeks. Still, their central message is clear: the screen is not the enemy of childhood movement skills. Coached, structured exergaming belongs alongside traditional games as a tool for breaking the spiral of inactivity, at school and at home.

Subject of Research: The effects of exergames on children's fundamental movement skills, examined through a systematic review and meta-analysis of methodological variables such as coaching and activity structure.

Article Title: The Effects of Exergames on Fundamental Movement Skills in Childhood: A Systematic Review and Meta-analysis

Article References: O’Brien, O., Kendrick, C., Ives, B., Yap, M. H., & Henry, J. (2026). The Effects of Exergames on Fundamental Movement Skills in Childhood: A Systematic Review and Meta-analysis. Sports Medicine – Open, 12(1), Article 139. https://doi.org/10.1186/s40798-026-01081-2

Image Credits: AI Generated

DOI: 10.1186/s40798-026-01081-2

Keywords: exergames, exergamoids, fundamental movement skills, children, physical activity, physical education, meta-analysis, motor skill development, coaching, screen time, childhood health, dynamic systems theory

The finding is striking precisely because all of the children studied were already participating in organized community sport, a setting often assumed to nurture the building blocks of physical literacy. Fundamental movement skills, often abbreviated as FMS, encompass the basic locomotor and object-control abilities, such as running, jumping, throwing and kicking, that underpin virtually all later physical activity. Decades of research have linked strong motor competence in childhood to higher levels of physical activity, better cardiorespiratory fitness, healthier body weight and sustained participation in sport and recreation through adolescence and into adulthood. Conversely, children with weak motor foundations tend to withdraw from physical activities, creating a self-reinforcing cycle of inactivity and further skill delay that public health researchers describe as a downward spiral.

To measure motor competence, the team used PLAYbasic, one of the Physical Literacy Assessment for Youth tools developed in Canada, which involves direct observation of children performing standardized tasks rather than relying on parental or self-report. Each child was asked to run, hop, throw, kick a ball and hold a balance, with trained assessors scoring technique against developmental criteria. In addition to the skill assessment, children completed the Physical Activity Questionnaire for Older Children, a validated self-report instrument known as the PAQ-C, while parents and guardians provided proxy-reported information on moderate-to-vigorous physical activity, outdoor play, the mode of travel to school, parental education and participation in coached sport.

The statistical analysis centered on multivariable linear regression, a technique that allows researchers to estimate the independent contribution of each factor while holding the others constant. In the primary adjusted model, two variables stood out as significant predictors of total FMS scores: older age and participation in coached sport. Together with the other covariates, the model explained 47.8 percent of the variance in skill scores, a substantial proportion for research in this field, with an adjusted R-squared of 0.454. The association between age and skill is expected, since motor competence typically improves as children mature and accumulate practice. The independent effect of coached sport, however, is the finding with the clearest practical implications, because unlike age, it is a potentially modifiable characteristic that communities and policy makers can act upon.

One of the more technically interesting results concerned kicking. The researchers detected a significant interaction between age and gender for kicking performance, meaning that the estimated difference between boys and girls in this skill was not constant across the age range but grew larger among older children. This pattern suggests that gender-related gaps in object-control skills may widen during the middle childhood years, possibly reflecting differences in the types of sport activities, practice opportunities or social encouragement that boys and girls receive as they get older. The authors note that such interactions are important to document because averaged effects can mask diverging developmental trajectories that matter for intervention design.

Perhaps counterintuitively, physical activity levels did not hold up as significant predictors once other factors were accounted for. Both child-reported physical activity on the PAQ-C and parent proxy-reported moderate-to-vigorous physical activity were associated with FMS scores in simple bivariate analyses, but neither remained statistically significant in the fully adjusted model. This dissociation between being active and being skilled carries an important message: the quantity of movement a child accumulates may matter less for motor development than the quality and structure of that movement. Unstructured play, while valuable for many aspects of health, may not by itself provide the instruction, repetition and feedback that children need to refine techniques such as a mature throwing pattern or a well-coordinated kick.

The study fills a notable gap in the literature because most motor competence research has been conducted in large urban centers, and evidence from northern and small-city Canadian settings has been scarce. Geographic context can shape skill development in multiple ways, from the availability and cost of sport programs to the length and severity of winters, the distances families must travel to facilities, and the capacity of local organizations to train coaches. Prince George, the northern British Columbia city where the study took place, experiences long winters and serves scattered surrounding communities, conditions that can constrain year-round access to structured physical activity programming. Understanding how motor competence develops in such settings is essential for designing equitable interventions rather than importing models validated only in major metropolitan areas.

The work was carried out as part of the Physical Literacy for Communities initiative, known as PL4C, which was supported through the Healthy Canadians and Communities Fund of the Public Health Agency of Canada along with financial and in-kind contributions from Sport for Life and its partners. The researchers partnered with Engage Sport North, a regional organization that helped recruit participants and facilitated data collection, and they acknowledge the children, parents, student volunteers and research assistants who made the assessments possible. The study received harmonized research ethics approval through the British Columbia RISe system under protocol H22-01044, and written informed consent was obtained from parents or guardians before any data collection began.

For the authors, the central takeaway is that participation alone is not enough. Even among children already connected to community sport, motor competence clustered at the lowest classification levels, indicating that enrollment does not guarantee the developmental instruction and deliberate practice that skill acquisition requires. They argue that structured, developmentally appropriate opportunities for instruction and skill practice should be embedded within community sport programming, with particular attention to children who join programs late or who receive less coaching exposure. The significant role of coached sport in their models suggests that expanding access to quality coaching, especially in northern and smaller communities where such resources are often limited, could be a concrete lever for improving child motor development and, by extension, long-term physical activity and health.

The researchers are careful to frame their conclusions within the limits of the study design. As a cross-sectional analysis, the study captures a single moment in time and cannot establish whether coached sport causes better motor skills or whether more skilled children are simply more likely to stay in coached programs. The sample of 166 children, while adequate for the regression models employed, was drawn from a single city, and two-thirds of the participants were boys, factors that may limit generalizability. The authors call for longitudinal and intervention studies to clarify the causal relationships and to identify concrete strategies for supporting fundamental movement skills, motor competence and broader physical literacy in northern and small-city contexts. Until such evidence accumulates, the study stands as a warning that the assumed pipeline from community sport participation to physical literacy may be leaking badly, and that deliberate, well-coached skill instruction is the repair it likely needs.

Subject of Research: Fundamental movement skill competence among children aged 6 to 12 participating in community sport programs in a northern Canadian city

Article Title: Fundamental movement skills among children participating in community sport programs in a northern Canadian city: implications for equitable access and physical literacy development

Article References: Fundamental movement skills among children participating in community sport programs in a northern Canadian city: implications for equitable access and physical literacy development. (n.d.). https://doi.org/10.1186/s12889-026-29440-4

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29440-4

Keywords: fundamental movement skills, physical literacy, motor competence, community sport, children, coached sport, physical activity, health equity, northern Canada, PLAYbasic, BMC Public Health, public health